Part B Payment Model Indexing Commercial Discounts Proposed By Genentech
Approach offered as alternative to more disruptive changes to Part B's existing buy-and-bill system; more aggressive proposals include new iteration of competitive acquisition program and moving Part B drug coverage to Part D.
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Unique NDCs, Medicare reimbursement codes would allow for lower list prices for the drugs when used in combination for lung cancer, Genentech says.
Two highly anticipated proposed rules in Medicare Part D are scheduled for near-term release.
CMS using authority from previously abandoned competitive acquisition program; vendors may get ability to use formularies and apply utilization management techniques like prior authorization and step therapy.